World Neurosurg
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Improved technology in vestibular neuroma resection and facial nerve protection has become more sophisticated, and the protection of hearing during vestibular schwannoma resection is crucial. Currently, brainstem auditory evoked potential (BAEP), cochlear electrography, and cochlear nerve compound action potential (CNAP) are frequently used. The CNAP waveform is stable; however, the recording electrode can easily affect the procedure and cannot map the auditory nerve. The purpose of the study was to explore a simple method to record the CNAP and map the auditory nerve. ⋯ The bipolar facial nerve stimulator can locate and protect the auditory nerve by recording a stable potential. The CNAP obtained rate was significantly higher than that of BAEP. The disappearance of BAEP during acoustic neuroma monitoring can be used as a standard alert for the surgeon, and decrease in CNAP is an alert for the operator.
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In a retrospective cohort study, we compared the outcomes among clinical and radiographic degenerative spondylolisthesis (CARDS) subtypes for patients undergoing posterior lumbar decompression and fusion (PLDF) or transforaminal lumbar interbody fusion (TLIF) and evaluated the CARDS system as a tool to guide clinical decisions regarding the treatment of degenerative spondylolisthesis (DS). ⋯ Patients with disc space collapse and endplate apposition (CARDS type A) appear to benefit from TLIF. However, patients with lumbar spondylolisthesis without disc space collapse or kyphotic angulation (CARDS types B and C) showed no benefit from additional interbody placement.
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Since the emergence of neurosurgery as a distinct specialty ∼100 years ago in Canada, it took >40 years for Canadian women to enter the field in the province of Quebec, and longer in the other provinces. ⋯ To the best of our knowledge, this study represents the first historical overview of female women neurosurgeons in Canada. Providing a historical context will help us to better understand the important role of women in modern neurosurgery, identify persistent gender issues in the field, and provide a vision for aspiring female neurosurgeons.
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To investigate the efficacy and safety of posterior atlantoaxial fusion (AAF) with C1-2 pedicle screw fixation for atlantoaxial dislocation (AAD) in pediatric patients with mucopolysaccharidosis IVA (MPS IVA). ⋯ Posterior AAF with C1-2 pedicle screw fixation is effective and safe for AAD in pediatric patients with MPS IVA. However, the procedure is technically demanding and should be performed by experienced surgeons with strict multidisciplinary consultations.
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Awake craniotomies are often performed with rigid pin fixation to support optical neuronavigation. Newer electromagnetic (EM) neuronavigation technology now enables unpinned cranial neurosurgery while maintaining robust intraoperative image guidance. Here, we share technical nuances, operative pearls, and lessons learned from our institutional experience using Curve EM neuronavigation during awake, unpinned craniotomies. ⋯ The technical pearls outlined here will help interested neurosurgeons integrate EM neuronavigation into awake craniotomies. In our experience, using unpinned neuronavigation during awake cases provides many advantages to the patient, surgeon, and entire operative team. It has thus become the standard practice at our institution.